Relationships Between Reproductive History and Mortality From Cardiovascular Diseases Among Japanese Women: The Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC) Study

Overview

Journal J Epidemiol

Specialty Public Health

Date 2019 Nov 19

PMID 31735742

Citations 5

Authors

Kanami Tanigawa

Satoyo Ikehara

Takashi Kimura

Hironori Imano

Isao Muraki

Kokoro Shirai

Akiko Tamakoshi

Hiroyasu Iso

Affiliations

Soon will be listed here.

Abstract

Background: Reproductive history has been addressed as a risk factor for cardiovascular disease (CVD). We examined the relationship between reproductive history and CVD mortality in Japanese women.

Methods: We followed 53,836 women without previous CVD or cancer history from 1988-1990 to 2009 in a prospective cohort study. Hazard ratios (HRs) and 95% confidence intervals (CIs) of CVD mortality were estimated according to the number of deliveries and maternal age at first delivery.

Results: During the follow-up, 2,982 CVD-related deaths were identified. There was U-shaped association between the number of deliveries and risk of CVD mortality with reference to three deliveries, although the excess risk of CVD mortality associated with ≥5 deliveries was of borderline statistical significance. The corresponding multivariable HRs were 1.33 (95% CI, 1.12-1.58) and 1.11 (95% CI, 0.99-1.24). In addition, higher CVD mortality was associated with maternal age ≥28 years at first delivery than maternal age of 24-27 years at first delivery. The multivariable HRs were 1.22 (95% CI, 1.10-1.36) for 28-31 years at first delivery and 1.26 (95% CI, 1.04-1.52) for ≥32 years at first delivery. Moreover, among women with ≥3 deliveries, maternal age ≥28 years at first delivery was associated with 1.2- to 1.5-fold increased CVD mortality.

Conclusion: The number of deliveries showed a U-shaped association with risk of CVD mortality. Higher maternal age at first delivery was associated with an increased risk of CVD mortality, and excessive risk in women aged ≥28 years at first delivery was noted in those with ≥3 deliveries.

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References

Lucas R, Azevedo A, Barros H . Self-reported data on reproductive variables were reliable among postmenopausal women. J Clin Epidemiol. 2008; 61(9):945-50. DOI: 10.1016/j.jclinepi.2007.11.001. View

Parikh N, Cnattingius S, Dickman P, Mittleman M, Ludvigsson J, Ingelsson E . Parity and risk of later-life maternal cardiovascular disease. Am Heart J. 2010; 159(2):215-221.e6. DOI: 10.1016/j.ahj.2009.11.017. View

Nicholson W, Asao K, Brancati F, Coresh J, Pankow J, Powe N . Parity and risk of type 2 diabetes: the Atherosclerosis Risk in Communities Study. Diabetes Care. 2006; 29(11):2349-54. DOI: 10.2337/dc06-0825. View

Yang C, Chang C, Kuo H, Chiu H . Parity and risk of death from subarachnoid hemorrhage in women: evidence from a cohort in Taiwan. Neurology. 2006; 67(3):514-5. DOI: 10.1212/01.wnl.0000227938.06750.ec. View

Rosendaal N, Pirkle C . Age at first birth and risk of later-life cardiovascular disease: a systematic review of the literature, its limitation, and recommendations for future research. BMC Public Health. 2017; 17(1):627. PMC: 5498883. DOI: 10.1186/s12889-017-4519-x. View

Chang H, Odongua N, Ohrr H, Sull J, Nam C . Reproductive risk factors for cardiovascular disease mortality among postmenopausal women in Korea: the Kangwha Cohort Study, 1985-2005. Menopause. 2011; 18(11):1205-12. DOI: 10.1097/gme.0b013e31821adb43. View

Mosca L, Benjamin E, Berra K, Bezanson J, Dolor R, Lloyd-Jones D . Effectiveness-based guidelines for the prevention of cardiovascular disease in women--2011 update: a guideline from the american heart association. Circulation. 2011; 123(11):1243-62. PMC: 3182143. DOI: 10.1161/CIR.0b013e31820faaf8. View

Desoye G, Schweditsch M, Pfeiffer K, Zechner R, Kostner G . Correlation of hormones with lipid and lipoprotein levels during normal pregnancy and postpartum. J Clin Endocrinol Metab. 1987; 64(4):704-12. DOI: 10.1210/jcem-64-4-704. View

Cirillo P, Cohn B . Pregnancy complications and cardiovascular disease death: 50-year follow-up of the Child Health and Development Studies pregnancy cohort. Circulation. 2015; 132(13):1234-42. PMC: 6938224. DOI: 10.1161/CIRCULATIONAHA.113.003901. View

10.

Lv H, Wu H, Yin J, Qian J, Ge J . Parity and Cardiovascular Disease Mortality: a Dose-Response Meta-Analysis of Cohort Studies. Sci Rep. 2015; 5:13411. PMC: 4547137. DOI: 10.1038/srep13411. View

11.

Sakauchi F . Reproductive history and health screening for women and mortality in the Japan Collaborative Cohort Study for Evaluation of Cancer (JACC). Asian Pac J Cancer Prev. 2008; 8 Suppl:129-34. View

12.

Chang S, Glymour M, Cornelis M, Walter S, Rimm E, Tchetgen Tchetgen E . Social Integration and Reduced Risk of Coronary Heart Disease in Women: The Role of Lifestyle Behaviors. Circ Res. 2017; 120(12):1927-1937. PMC: 5476459. DOI: 10.1161/CIRCRESAHA.116.309443. View

13.

Grundy E, Kravdal O . Fertility history and cause-specific mortality: a register-based analysis of complete cohorts of Norwegian women and men. Soc Sci Med. 2010; 70(11):1847-57. DOI: 10.1016/j.socscimed.2010.02.004. View

14.

Tamakoshi A, Ozasa K, Fujino Y, Suzuki K, Sakata K, Mori M . Cohort profile of the Japan Collaborative Cohort Study at final follow-up. J Epidemiol. 2013; 23(3):227-32. PMC: 3700254. DOI: 10.2188/jea.je20120161. View

15.

Barclay K, Keenan K, Grundy E, Kolk M, Myrskyla M . Reproductive history and post-reproductive mortality: A sibling comparison analysis using Swedish register data. Soc Sci Med. 2016; 155:82-92. DOI: 10.1016/j.socscimed.2016.02.043. View

16.

Steenland K, Lally C, Thun M . Parity and coronary heart disease among women in the American Cancer Society CPS II population. Epidemiology. 1996; 7(6):641-3. DOI: 10.1097/00001648-199611000-00014. View

17.

Jacobs M, Kritz-Silverstein D, Wingard D, Barrett-Connor E . The association of reproductive history with all-cause and cardiovascular mortality in older women: the Rancho Bernardo Study. Fertil Steril. 2011; 97(1):118-24. PMC: 3245788. DOI: 10.1016/j.fertnstert.2011.10.028. View

18.

Dior U, Hochner H, Friedlander Y, Calderon-Margalit R, Jaffe D, Burger A . Association between number of children and mortality of mothers: results of a 37-year follow-up study. Ann Epidemiol. 2012; 23(1):13-8. PMC: 3520435. DOI: 10.1016/j.annepidem.2012.10.005. View

19.

Stephansson O, Dickman P, Johansson A, Cnattingius S . Maternal weight, pregnancy weight gain, and the risk of antepartum stillbirth. Am J Obstet Gynecol. 2001; 184(3):463-9. DOI: 10.1067/mob.2001.109591. View

20.

Green A, Beral V, Moser K . Mortality in women in relation to their childbearing history. BMJ. 1988; 297(6645):391-5. PMC: 1834270. DOI: 10.1136/bmj.297.6645.391. View